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Individual

COREY L THOMPSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
4340 E INDIAN SCHOOL RD, STE 21-562, PHOENIX, AZ 85018-5360
(480) 545-2610
(480) 545-2673
Mailing address
4340 E INDIAN SCHOOL RD, STE 21-562, PHOENIX, AZ 85018-5360
(480) 545-2610
(480) 545-2673

Taxonomy

Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
AZ 2069
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
384678
AZ
01
AW7564
AZ HEALTHNET
AZ
01
AZ0147940
AZ BCBS
AZ
01
HN3Z0381
AZ HEALTHNET
AZ
Enumeration date
07/18/2006
Last updated
12/22/2014
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